Early electrographic seizures, brain injury, and neurodevelopmental risk in the very preterm infant

Zachary A Vesoulis, Terrie E Inder, Lianne J Woodward, Bradley Buse, Claudine Vavasseur, Amit M Mathur, Zachary A Vesoulis, Terrie E Inder, Lianne J Woodward, Bradley Buse, Claudine Vavasseur, Amit M Mathur

Abstract

Background: Previous studies of very preterm (VPT) infants have shown a wide range of seizure prevalence and association with intraventricular hemorrhage (IVH), white matter injury (WMI), and death. However, the impact of seizures on neurodevelopment is not well known. We hypothesized that seizures in the first 3 d after VPT birth would be associated with increased radiographic brain injury and later neurodevelopmental risk.

Methods: For 72 h after birth, 95 VPT infants underwent amplitude-integrated electroencephalogram monitoring. High and low seizure burdens were related to radiographic brain injury, death in the neonatal period, and children's Bayley III (Bayley Scales of Infant Development) performance at 2 y corrected age in a subgroup of 59 infants.

Results: The overall incidence of seizures in this sample was 48%. High seizure burden was associated with increased risk of IVH on day 1; IVH, WMI, and death on day 2; and high-grade IVH on day 3. The presence of seizures on any day was associated with decreased language performance at age 2, even after controlling for family social risk.

Conclusion: Seizures during the first 3 d after birth are common and are associated with an increased risk of IVH, WMI, and death. They were also associated with poorer early language development.

Conflict of interest statement

Disclosure: None of the authors of this manuscript have any conflicts of interest or financial disclosures to report

Figures

Figure 1. Overview of study design
Figure 1. Overview of study design
Overview of study design depicting number of participants for each stage of analysis and the reason for exclusion.
Figure 2. Frequency distribution of seizures
Figure 2. Frequency distribution of seizures
Histogram depicting cumulative number of seizures during the first 72 hours after birth.

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